Gregory James Piacente, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

ME63890 Issued in FL

Practice address

1106 Hospital Road
Neurology Department
Fort Walton Beach, FL 32547

Phone

(850) 863-8253

Fax

(850) 863-7045

NPI assigned

Dec 15, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484524800000",
    "number": "1063498723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 HOSPITAL ROAD",
            "address_2": "NEUROSCIENCE CENTER",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "32547",
            "telephone_number": "850-863-8253",
            "fax_number": "850-863-7045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 HOSPITAL ROAD",
            "address_2": "NEUROLOGY DEPARTMENT",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "32547",
            "telephone_number": "850-863-8253",
            "fax_number": "850-863-7045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIACENTE",
        "first_name": "GREGORY",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2017-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME63890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "372892700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL",
            "identifier": "18816",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• PHC-Ft Walton Inc
• Rachel Mikaela Phillips
• Tanya Phillips
• Phoenixco.
• Physiatry Pain Management, P.a
• Katherine Pina
• Joshua Pinkston, AGACNP-BC
• Carly Mae Pippin, DPT
• Kelly Anne Pippins
• Brian S Planchard, MD

• Neurology Physician in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Neurology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.